Garry Rayno's State House Dome: Medicaid hearing to air questions

On Tuesday, the Commission to Study Expansion of Medicaid Eligibility will meet to hear stakeholders - read: health care providers - and the public.

After this meeting, Chairman Jim Varnum said, the commission should be able to begin drafting its recommendations, which have to be finalized by Oct. 15. Varnum said the committee will call back state officials and hear from other parties as its work on details proceeds.

The first stakeholder the commission is scheduled to hear is the NH Hospital Association's Henry Lipman of Lakes Region General Hospital.

Hospitals want Medicaid eligibility expanded under the Affordable Care Act. If the state decides to expand eligibility, health care providers - mostly hospitals - will receive $2.4 billion from the federal government over the next seven years.

While hospitals would actually do better if Medicaid were not expanded and those newly eligible under the ACA went onto private health insurance instead, the hospitals continue to push for the expansion.

Currently, the state's largest hospitals receive little state help covering the cost of treating patients who do not pay for care. There is about $40 million in state general fund money in the budget that can be used to match an equal amount of federal money to help hospitals with their uncompensated care costs.

But the federal Disproportionate Share Hospital program will disappear under the ACA as more people get health insurance. After the DSH program ends, the hospitals want to ensure they receive at least some money for the care they provide.

Opponents of expansion also view Tuesday's hearing as their chance to be heard. They claim the only anti-expansion expert to testify to date was at the commission's last meeting, when Christina Herrera of the Foundation for Government Accountability appeared.

"In my opinion, I don't think there is one good reason to expand Medicaid," Herrera told the commission. "I would work to make private insurance more affordable or stand pat on Medicaid."

Groups supporting expansion are also expected to turn out for the meeting, scheduled to run from 1 to 4 p.m.

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The Other Shoe: When the Senate meets the day after Labor Day, Chuck Morse, R-Salem, will most likely take over the Senate president post.

Morse has lined up support from nearly all the Senate Republicans, who hold a 13-11 edge over Democrats in the body.

But with more than a week to go before the vote - a week can be a lifetime in politics - there is still time for political mischief.

The big unknown is what the Democrats will do. Are they willing to cut a deal with a Republican or two to forge an unholy alliance to control Senate leadership?

The smart money says the answer is no.

The Senate has taken a bit of a beating since Senate President Peter Bragdon announced two weeks ago he would become the Local Government Center's new executive director. The controversy grew, and by last Friday, Bragdon had announced he would step down as president.

Wednesday evening, the LGC released emails and other documents detailing Bragdon's pursuit of the job. There is nothing in what was released that could be a deal breaker for the LGC or Bragdon, and eventually life will go on.

Bragdon, who will remain District 11 senator, will probably have to recuse himself from some significant votes.

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Looking for Help: Karen Testerman, who announced she is exploring a run for the Republican nomination to the U.S. Senate, sent an email around at the end of last week asking people to help her with her campaign.

"The America of today is weak and failing because bureaucracies in Washington restrict the choices of the individual thru punitive taxes, onerous rules and overreaching regulations. Washington is running amok. We need the will to refocus on the constitutional blueprint to restore liberty to you, the American people," she wrote.

If she receives 5,000 signatures from supporters on her website - DraftKaren.com - she will run, she said. Testerman also asks people to contribute $10 to her effort by becoming a "Founder of Karen."

"With your help we can make a difference," she wrote.

Testerman ran for governor in 2010, finishing third in the four-way Republican primary won by John Stephen.

Labor Day Breakfast: Gov. Maggie Hassan and U.S. Sen. Jeanne Shaheen will speak at the New Hampshire AFL-CIO 2013 Labor Breakfast on Sept. 2 at St. George Greek Orthodox Cathedral, Hanover Street, Manchester.

Also speaking will be State Labor Commissioner James Craig and Employment Security Commissioner George Copadis.

"Working men and women and middle-class families took the brunt of the recent economic recession, and many of the good jobs with living wages we lost during the downturn have not returned to New Hampshire," said NH AFL-CIO President Mark MacKenzie. "We use the tradition of Labor Day to honor the extraordinary contribution that ordinary working people make to New Hampshire's economic growth and the quality of life in our communities."